Document Detail

Projections of hypertension-related renal disease in middle-aged residents of the United States.
MedLine Citation:
PMID:  8437305     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To establish nationwide projections for hypertension-related renal disease among middle-aged residents of the United States and compare disease burden in demographic subgroups.
DESIGN: Integrated analysis of data from the US Census, the National Health and Nutrition Examination Survey of 1976 through 1980 (NHANES II), the 1971 through 1975 NHANES I Epidemiologic Follow-up Study, the Hypertension Detection and Follow-up Program trial, and the US Renal Data System.
POPULATION: African-American and white residents of the United States, aged 30 to 69 years.
MAIN OUTCOME MEASURES: Incidence rates and counts of hypertension, hypertension-related hypercreatinemia, and hypertension-related end-stage renal disease (ESRD).
RESULTS: Each year, approximately 1.8 million middle-aged Americans develop hypertension, 140,000 develop hypertension-related hypercreatinemia, and 5300 develop hypertension-related ESRD. African Americans are at increased risk for hypertension (relative risk [RR], 1.6; population-attributable risk [PAR], 5%), hypercreatinemia if hypertensive (RR, 2.4; PAR, 18%), ESRD if hypertensive with hypercreatinemia (RR, 2.7; PAR, 32%), and hypertension-related ESRD overall (RR, 8.0; PAR, 44%). Compared with women, men are at increased risk for hypertension (RR, 1.3; PAR, 13%) and hypertension-related ESRD (RR, 1.6; PAR, 23%). Most cases of hypercreatinemia in hypertensives (73%) occur among those with mild hypertension.
CONCLUSIONS: Progression to ESRD is rare in persons with hypertension-related renal disease, and factors other than blood pressure probably play an important role. A large proportion of hypertension-related renal disease cases occur among population subgroups considered to be at low risk. Interventions that favorably influence factors associated with the progression of hypertension-related renal disease in African Americans, in men, and in persons with mild hypertension, hold the greatest potential for reducing the population burden of hypertension-related ESRD.
T V Perneger; M J Klag; H I Feldman; P K Whelton
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JAMA     Volume:  269     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-03-22     Completed Date:  1993-03-22     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1272-7     Citation Subset:  AIM; IM    
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MeSH Terms
African Continental Ancestry Group
Creatinine / blood
Data Collection
European Continental Ancestry Group
Hypertension / epidemiology,  ethnology,  physiopathology*
Kidney Failure, Chronic / epidemiology*,  ethnology,  physiopathology
Middle Aged
Risk Factors
United States / epidemiology
Grant Support
Reg. No./Substance:

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